Journal of the American Veterinary Medical Association · 2021
Diagnosis of a tracheal tear by use of an oxygen analyzer in a dog with cervical trauma.
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Walters Kate L, Knight Rebekah C
Аннотация
CASE DESCRIPTION: A 7.75-year-old sexually intact male Welsh Terrier was examined because of cervical soft tissue wounds and an inability to maintain hemoglobin oxygen saturation without oxygen supplementation following a dog attack.
CLINICAL FINDINGS: A 2-cm-long penetrating wound that extended into a large open pocket was identified on the left ventral aspect of the dog's neck. The dog was anesthetized and underwent advanced imaging, the findings of which suggested that the trachea was intact. However, when the cuff of the endotracheal tube was deflated during the dog's recovery from anesthesia, sudden oxygen desaturation occurred. Given no radiographic signs of deteriorating lung injury, a tracheal tear was suspected. For rapid confirmation of a tracheal tear, without the need for additional advanced imaging, the oxygen concentration at the skin wound was investigated by use of an oxygen analyzer. When the dog was breathing 100% oxygen, the analyzer identified a higher oxygen concentration at the edge of the penetrating wound, compared with the concentration of oxygen in room air; the leakage of oxygen-rich gases from the airway through the wound confirmed the presence of a tracheal tear, immediately indicating the need for surgical exploration and repair.
TREATMENT AND OUTCOME: Surgical repair of the tracheal tear with a left sternothyroideus muscle flap was successfully performed.
CLINICAL RELEVANCE: For this dog, an oxygen analyzer was used to confirm the presence of a tracheal tear, suggesting that application of an oxygen analyzer may be useful in the emergency management of neck trauma cases.
CLINICAL FINDINGS: A 2-cm-long penetrating wound that extended into a large open pocket was identified on the left ventral aspect of the dog's neck. The dog was anesthetized and underwent advanced imaging, the findings of which suggested that the trachea was intact. However, when the cuff of the endotracheal tube was deflated during the dog's recovery from anesthesia, sudden oxygen desaturation occurred. Given no radiographic signs of deteriorating lung injury, a tracheal tear was suspected. For rapid confirmation of a tracheal tear, without the need for additional advanced imaging, the oxygen concentration at the skin wound was investigated by use of an oxygen analyzer. When the dog was breathing 100% oxygen, the analyzer identified a higher oxygen concentration at the edge of the penetrating wound, compared with the concentration of oxygen in room air; the leakage of oxygen-rich gases from the airway through the wound confirmed the presence of a tracheal tear, immediately indicating the need for surgical exploration and repair.
TREATMENT AND OUTCOME: Surgical repair of the tracheal tear with a left sternothyroideus muscle flap was successfully performed.
CLINICAL RELEVANCE: For this dog, an oxygen analyzer was used to confirm the presence of a tracheal tear, suggesting that application of an oxygen analyzer may be useful in the emergency management of neck trauma cases.